rifampin and Orchitis

Genitourinary tuberculosis was diagnosed in 543 patients in Spanish hospital from 1978 through 2003. Of the 371 male 34 (9.2%) had orchiepididymitis. Mean age was 52.7 years and the presenting symptom was scrotal swelling and/or pain. Over 50% of cases involved the right ovotestis. Associated renal tuberculosis and active disease in extraurological organs presented in 64% and 19.2% of cases, respectively. Diagnosis was established by culture of Mycobacterium tuberculosis recovery from urine and/or purulent scrotal exudate. Genomic amplification techniques aided the diagnosis in 8 patients. Treatment was rifampin, isoniazide, and pyrazinamide or ethambutol. Eight patients required combined medical and surgical treatment.

Topics: Adult; Aged; Aged, 80 and over; Antitubercular Agents; Combined Modality Therapy; Comorbidity; Epididymitis; Ethambutol; Exudates and Transudates; HIV Infections; Humans; Isoniazid; Male; Middle Aged; Mycobacterium tuberculosis; Orchitis; Prostatitis; Pyrazinamide; Retrospective Studies; Ribotyping; Rifampin; RNA, Ribosomal, 16S; Scrotum; Spain; Tuberculosis, Male Genital; Tuberculosis, Renal; Urine

To review the clinical and laboratory features and response to treatment of patients with acute brucellar epididymo-orchitis reporting to a tertiary care hospital in Riyadh, and to compare these with other cases reported previously.. In this retrospective study, records of all 26 adult patients with brucellosis, who presented with epididymitis or epididymo-orchitis at a tertiary hospital in Riyadh from 1983 to 2000, were reviewed. Positive blood culture or high agglutination titres of > or = 1 : 320 and positive clinical manifestations of brucellosis were the main criteria for diagnosing brucellosis. Among these cases, epididymitis or epididymo-orchitis was diagnosed on the basis of a typical history of gradual onset of scrotal pain and findings of enlarged tender testes and/or epididymis.. Epididymo-orchitis occurred in 1.6% of all patients with brucellosis. Most (58%) were 25--44 years old; approximately 77% of the patients presented with acute symptoms of < 2 weeks' duration. All patients complained of swollen painful testicles. Other presenting symptoms included undulant fever (96%), chills (54%) and arthralgia (23%). Four patients had dysuria and one haematuria. Ten patients gave a positive history of ingestion of raw milk and milk products; one patient had laboratory-acquired brucellosis. Six patients had unilateral epididymo-orchitis (two with features of florid presentation); the remaining 20 had only orchitis (bilateral in two, right in 10 and left in eight). Leucocytosis was present in six patients; 25 had initial agglutination titres of > 1 : 320 and the remaining patient had a positive blood culture. All patients received combined therapy with streptomycin for the first 2 weeks (or oral rifampicin for 6 weeks) with doxycycline or tetracycline for 6 weeks. All showed improvement, fever subsided in 2--5 days and the scrotal enlargement and tenderness regressed. Only one patient had a relapse within one year.. In brucellosis-endemic areas, clinicians encountering epididymo-orchitis should consider the likelihood of brucellosis. A careful history, a meticulous physical examination and a rapid laboratory evaluation help in diagnosis. Clinical and serological data are sufficient for diagnosis. Leucocytosis is not an atypical feature of brucellar epididymo-orchitis and so cannot be used for differentiating it from the nonspecific variety. Conservative management with combination antibiotic therapy is adequate for managing brucellar epididymo-orchitis.

Topics: Adolescent; Adult; Aged; Brucellosis; Doxycycline; Drug Therapy, Combination; Epididymitis; Fever; Humans; Length of Stay; Male; Middle Aged; Orchitis; Retrospective Studies; Rifampin; Saudi Arabia; Streptomycin; Tetracycline

Brucellosis is an endemic disease in Turkey, and testicular abscess is a rare and frequently misdiagnosed complication of brucellosis. In the literature there are only seven reported cases, and all were treated with both medical and surgical therapy. We report a case of brucellar testicular abscess treated with medical therapy only. Although the patient recovered clinically at the end of 6 weeks, the regression of the testicular lesion could not be observed until after 5 months.

Topics: Abscess; Adult; Anti-Bacterial Agents; Brucellosis; Doxycycline; Epididymitis; Humans; Male; Orchitis; Rifampin; Testicular Diseases; Turkey

Diagnosis of extrapulmonary tuberculosis (TB) is often missed or delayed because of nonspecific clinical and laboratory findings. Novel detection methods, such as polymerase chain reaction and QuantiFERON-TB Gold In Tube, can aid in the diagnosis of active extrapulmonary TB. Here, we demonstrate a case of epididymo-orchitis as the sole presentation of TB in a 32-year-old man.

Topics: Adult; Antibiotics, Antitubercular; Enzyme-Linked Immunosorbent Assay; Epididymitis; Humans; Male; Orchitis; Polymerase Chain Reaction; Rifampin; Testis; Tuberculosis, Male Genital; Ultrasonography

Topics: Adolescent; Anti-Bacterial Agents; Antibodies, Bacterial; Brucella melitensis; Brucellosis; Doxycycline; Humans; Male; Orchitis; Rifampin; Testis; Ultrasonography

Topics: Adult; Anti-Bacterial Agents; Brucellosis; Doxycycline; Drug Therapy, Combination; Epididymitis; Humans; Male; Orchitis; Recurrence; Rifampin; Scrotum; Treatment Outcome; Ultrasonography

To study the clinical spectrum of brucellosis in Bikaner (Northwest India).. A total of 175 cases were diagnosed as brucellosis during the period of six year (June 1997 to May 2003). They were studied for clinical profile and treated by rifampicin and doxycyclin and additionally streptomycin for initial 14 days in patients of neurobrucellosis. These patients were followed up to 3 months.. Patients of brucellosis presented with a wide spectrum of clinical manifestations. Out of 175 cases 155 were from rural area. Age ranged between 12-60 years (124 males, 51 females). Analysis of risk factors revealed history of raw milk ingestion (86.86%), occupational contact with animals (81.14%), handling of infected material (62.28%), household contact (16%) and 2 patients were veterinarian. Joint pain (83.43%) and fever (77.71%) were the commonest presenting feature. Sacroiliac joint was most commonly involved (46.86%). 31 cases had involvement of multiple joints. Other mode of presentation were neurobrucellosis (18.86%), manifested as polyradiculoneuropathy, myeloradiculopathy, meningoencephalopathy and polyradiculomyeloencephalopathy; predominant pulmonary involvement (4.0%) presented as bronchitis, pneumonia and pleural effusion; epididymoorchitis, infective endocarditis, nephrotic syndrome and recurrent abortion. All patients responded well to the treatment.. Brucellosis is an important emerging zoonotic disease but it is often under-diagnosed due to lack of suspicion and diagnostic facilities despite the fact that cattle farming (an important high risk group) is one of the main occupation in rural area. This report should infuse the awareness about this reemerging disease specifically in high-risk group.

Topics: Adolescent; Adult; Animals; Anti-Bacterial Agents; Arthritis, Infectious; Brucellosis; Child; Doxycycline; Female; Follow-Up Studies; Food Microbiology; Humans; India; Male; Meningoencephalitis; Middle Aged; Milk; Occupational Diseases; Orchitis; Pleural Effusion; Prospective Studies; Rifampin; Risk Factors; Rural Health; Streptomycin

Brucellosis is a significant public health problem particularly in developing countries. People are frequently infected through milk, milk products, urine and pregnancy material of animals with brucellosis. Epididymoorchitis is the most frequent genitourinary complication of brucellosis and is often unilateral. In this report, a 35 years old male patient who was diagnosed as epididymoorchitis based on clinical presentation, laboratory findings and imaging techniques, has been presented. Brucella melitensis was isolated from blood, bone marrow and ejaculate cultures of the patient. The patient was treated with rifampicine and doxycycline combination therapy for six weeks and no complication has developed in the one year follow-up period. In areas where brucellosis is endemic, such as our country, Brucella infection should be considered in the differential diagnosis of epididymoorchitis and in addition to blood and bone marrow cultures, ejaculate cultures should also be evaluated.

Topics: Adult; Anti-Bacterial Agents; Bacteremia; Bone Marrow; Brucella melitensis; Brucellosis; Diagnosis, Differential; Doxycycline; Epididymitis; Humans; Male; Orchitis; Rifampin; Semen

Topics: Anti-Bacterial Agents; Brucella abortus; Brucellosis; Doxycycline; Drug Therapy, Combination; Epididymitis; Humans; Male; Middle Aged; Oligospermia; Orchitis; Recurrence; Rifampin

To present epidemiologic, clinical and laboratory features, treatment and outcome of patients suffering from Brucella melitensis-induced epididymo-orchitis, in comparison with cases of nonspecific epididymo-orchitis. Distinction between these two entities is essential, as treatment and outcome are entirely different.. In this retrospective study, records of 17 patients serologically diagnosed as suffering from B. melitensis epididymo-orchitis were reviewed in comparison with 141 cases of non-Brucella epididymo-orchitis. All patients presented consecutively at a tertiary hospital in southwestern Greece, from 1991 to 2000. Statistical analysis was performed using the chi-square test.. B. melitensis epididymo-orchitis differed from nonspecific epididymo-orchitis, due to its high occupational risk, seasonal pattern, gradual onset (P<0.01), longer duration, typical undulatory fever (P<0.05), absence of serious leukocytosis (P<0.05) and lower urinary tract symptoms, and relatively minimal local signs of florid inflammation (P<0.01). Oral medication with doxycycline and rifampicin for 6 weeks was effective, and no relapses or serious side effects were recorded during the follow-up period.. B. melitensis-induced epididymo-orchitis is a recognized clinical problem in endemic regions, requiring early detection and appropriate medication. Clinicians encountering epididymo-orchitis should consider the likelihood of brucellosis and initiate anti-Brucella medication upon clinical diagnosis and not only after serologic confirmation.

Topics: Anti-Bacterial Agents; Brucella melitensis; Brucellosis; Doxycycline; Endemic Diseases; Epididymitis; Greece; Humans; Male; Orchitis; Retrospective Studies; Rifampin; Treatment Outcome

This paper describes a case of systemic brucellosis accompanied by brucellar orchitis that resolved favourably. There was however a relapse at the testicular level inappropriately treated that triggered a new episode of systemic brucellosis.

Topics: Adult; Anti-Infective Agents; Brucellosis; Doxycycline; Epididymitis; Humans; Male; Orchitis; Recurrence; Rifampin; Streptomycin

Eighteen patients with epididymo-orchitis were reviewed clinically, microbiologically and serologically. While there were positive urine culture in 5 patients before treatment, only one of them had positive culture in the epididymal aspirate. The epididymo-orchitis in two patients was the complications of the brucellosis. Ofloxacin or doxycycline was used in the treatment of 16 patients for 2-3 weeks and all, except one patient were recovered completely. The cases secondary to the brucellosis were treated with rifampicin plus doxycycline combination for 6 weeks. After treatment, no positive urine cultures were noted in all patients. As a result the epididymal aspiration to clarify etiological agent is not necessarily needed and empirical treatment may be generally curative.

Topics: Adolescent; Adult; Bacteriuria; Brucellosis; Doxycycline; Drug Therapy, Combination; Epididymitis; Escherichia coli; Escherichia coli Infections; Humans; Male; Middle Aged; Ofloxacin; Orchitis; Prospective Studies; Rifampin